Study Explores Disease Concepts in Amazonian Tribal Culture

UCSF researcher and Christopher Herndon visits with residents of a Hoti village in Venezuela’s Amazon region.

The use of medicinal plants by tribal cultures throughout the world is widely recognized and has led to the development of some of Western medicine’s most important pharmaceuticals. Yet few researchers have reported on how indigenous healers diagnose and characterize disease, or how that knowledge guides their treatment decisions.

UCSF clinical fellow and reproductive medicine specialist Christopher Herndon, MD, set out to fill that knowledge gap, focusing specifically on the Trio tribe in the rainforests of South America. His resulting study, published in October in the Journal of Ethnobiology and Ethnomedicine, is the first to examine patterns of disease recognition and treatment by Amazonian tribal healers, he said.

Herndon and his colleagues selected two remote Trio villages in Suriname and conducted an exhaustive analysis of more than 20,000 patient visits to shamans at traditional clinics over a four-year period.

Herndon called the study “a unique window of scientific opportunity,” noting that the researchers benefitted both from the wisdom of elder shamans, and also from the younger village healers who had been taught basic writing skills by missionaries and were able to document the disease diagnoses and prescribed treatments at the clinics.

Amasina Uremaru, above, is a Trio shaman in Suriname and co-author with UCSF researcher Christopher Herndon of a recent study of Trio disease concepts and treatment.

“Our close collaboration with the shamans and the wide utilization of the traditional clinics by the Trio communities permitted an unprecedented breadth and depth of insight into their healing system,” Herndon said.

The researchers found that the Trio healers recognize more than 70 distinct disease conditions and are able to identify the combined symptoms and characteristics of each disease.

“They frequently commented on disease associations and responsiveness to therapy, often demonstrating a remarkable insight into the natural history of disease processes as we understand them,” Herndon said.

Vast Knowledge of Disease

The shamans’ disease concepts range from generalized conditions, such as fever, to rare and specific conditions such as Bell’s palsy, the researchers found.

UCSF researcher Christopher Herndon examines a sick child with a healer from the Eñepa tribe of Venezuela.

In addition, their notions of disease correspond — at least approximately — to disease constructs within Western medicine. For example, the Trio recognize three distinct respiratory conditions that correspond closely to Western concepts of upper respiratory tract infection, pneumonia and tuberculosis.

“These healers have a rich and comprehensive knowledge of disease, which few scientists have sought to examine,” Herndon said. “This has contributed to a prevailing view in Western medicine that indigenous healers’ medical knowledge is comparatively primitive. Our study’s findings challenge this preconception.”

Herndon said he wasn’t surprised by the shamans’ highly developed understanding of disease, given their well-documented therapeutic knowledge.

Herndon first became interested in studying indigenous cultures while studying botany in college, he said. In medical school, he became involved with the nonprofit Amazon Conservation Team (ACT), which collaborates with indigenous peoples to conserve Amazonian biodiversity, health and culture.

ACT partnered with the regional health care provider, Medische Zending Suriname, to help the Trio open the clinics where Herndon conducted his research.

Herndon hopes his work will promote greater awareness among health and conservation organizations and encourage the development of programs that strengthen the traditional medicine systems of indigenous peoples.

“Our Western medical system is itself a compendium of knowledge, wisdom and therapeutics accumulated from past cultures and societies from around the world,” Herndon recently told the tropical conservation news site Mongabay.com. “We should not be so quick to sever the umbilical cord of our medical system from the womb of the last remaining cultures that helped gave it birth. We do so at our great loss.”